Selection of patients with Tourette syndrome for deep brain stimulation surgery

Deep brain stimulation (DBS) is an emerging therapeutic option for severe resistant Tourette syndrome (TS). To date, about 100~cases have been reported in the scientific literature. Different clinical guidelines have been proposed for this procedure from both USA and European centres. A number of issues remain unresolved, mainly in relation to eligibility criteria of patients with TS. We highlight the need for a comprehensive assessment of associated co-morbidities, which are not considered integral part of the syndrome and are not sufficiently evaluated in relation to DBS. The concept of refractoriness, the minimum age of candidates, and the optimal targets for DBS are also controversial.